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Obama Boosts Pledge 38% to Global Fund for AIDS, TB

The Obama administration boosted its pledge to the Global Fund to Fight AIDS, Tuberculosis & Malaria by 38 percent, to $4 billion, while urging changes to make the organization more efficient and more accountable.

The contribution brings the total pledge from donor countries to $11.7 billion over three years, the fund said in a statement today. The U.S. money comes with requirements to monitor how well the Global Fund’s programs work with local populations, said Eric Goosby, U.S. Global AIDS Coordinator, in a conference call with reporters today. The U.S. will base future donations on the group’s effectiveness, Goosy said.

President Barack Obama’s budget for global health, announced in February, reduced the U.S. pledge to the fund, in favor of expanding programs for child and maternal health. Today’s increase signals to other nations that the U.S., the fund’s largest donor, remains committed to distributing global health aid through the Geneva-based organization.

“The unmet need is extraordinary,” Goosby said. “There really is no stronger supporter to the global fund than the U.S. That’s a fact.”

The Global Fund was started in 2002 to fight diseases affecting the poorest nations. It’s responsible for providing a quarter of international financing for AIDS, two-thirds for tuberculosis and three-quarters for malaria, according to the fund’s website.

France, Japan Pledges

The U.S. was the first and largest contributor, giving more than $5.1 billion since the fund’s inception. Today’s pledge followed increases from France and Japan and is being welcomed by the AIDS community, said Mitchell Warren, executive director of the New York-based AIDS Vaccine Advocacy Coalition, a nonprofit group, in an interview.

“U.S. funding is a bellwether,” Warren said in a telephone interview. “This is an endorsement, showing that there’s not a single funding mechanism the U.S. is committed to, but several.”

The demand that the fund develop a clear plan of timelines and measures of progress creates a “carrot and stick” approach to the pledge that will help make the agency more effective, Warren said.

The New York-based advocacy group Health GAP released a statement saying the funding was insufficient to meet the challenge of the AIDS pandemic. The group expressed “profound disappointment” with the U.S. pledge, saying Obama “had the opportunity to lead the world toward sufficient funding for AIDS and failed to do so.”

More Therapy

The Global Fund estimated that with the U.S. assistance announced today, the group will be able to increase the number of AIDS patients on antiretroviral therapy 75 percent by 2015, to 4.4 million, according to a statement from the U.S. State Department.

Yearly tuberculosis treatments will almost triple to 3.9 million, from 1.4 million last year, the agency said. The number of bed nets for malaria prevention will triple to 110 million.

The $11.7 billion pledged today is more than a 20 percent increase over the $9.7 billion announced in 2007. It falls short of the $13 billion needed to maintain funding to current programs and the $20 billion required to expand them, Doctors Without Borders said.

“Ambitious country programs, which could mean the difference between life and death, may no longer be feasible,” said Jennifer Cohn, an AIDS policy adviser for Doctors Without Borders, in a statement. “This decision will result in the death of millions of people from otherwise treatable diseases.”

Plans Postponed

Michel Kazatchkine, the fund’s executive director, said that while all current programs will continue, some plans for expansion will have to be postponed. He said the fund would have to abandon for now plans to target maternal and child health.

“If it were the last word, it is not enough,” Kazatchkine told reporters. “The effort of scaling up will slow down, compared to what we were hoping for. We may face difficult decisions. We will have to redouble our efforts.”

Other contributions to the fund included $1.48 billion from France, $822.4 million from Germany, $800 million from Japan, and $528.4 million from Canada. More than 40 nations, the European Commission, foundations and companies made pledges. San Ramon, California-based Chevron Corp., the second-largest U.S. oil company, pledged $25 million.

“At a time when many governments are tightening their belts at home, these commitments send a powerful message,” UN Secretary-Ban Ki-moon said. “It shows how seriously world leaders want to do the right thing beyond their borders.”

Still, Ban said the shortfall means the fund would have to seek “other sources” of income, including companies.

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